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Comparison of techniques for identification of peripheral vestibular nystagmus

Comparison of techniques for identification of peripheral vestibular nystagmus
Comparison of techniques for identification of peripheral vestibular nystagmus

OBJECTIVE: To determine the best clinical method for identifying peripheral vestibular nystagmus, by comparing eye movement examination with optic fixation, and with fixation removed using Frenzel's glasses, infra-red video-Frenzel's goggles or an ophthalmoscope, with results of electronystagmography.

METHOD: One hundred patients referred for electronystagmography from the audiovestibular medicine clinic at Queen Alexandra Hospital, Portsmouth, were examined immediately before undergoing electronystagmography.

RESULTS: Video-Frenzel's goggles were highly effective at detecting peripheral vestibular nystagmus, with a sensitivity of 85 per cent (95 per cent confidence interval, 62.1-96.8 per cent) and a specificity of 65 per cent (53.5-75.3 per cent), compared with electronystagmography. Ophthalmoscopy had comparable sensitivity to Frenzel's glasses (used in the dark), i.e. 26.3 per cent (9.1-51.2 per cent) compared with 31.6 per cent (12.6-56.6 per cent), respectively. Frenzel's glasses as normally used in ENT clinics (i.e. in dim lighting) were ineffective, with a sensitivity of just 10 per cent (1.2-31.7 per cent).

CONCLUSION: Video-Frenzel's goggles should be used in all clinics with substantial numbers of balance-impaired patients. Traditional Frenzel's glasses have no place in clinical practice unless formal black-out facilities are available.

Diagnosis, Differential, Electronystagmography, Eyeglasses, Female, Fixation, Ocular, Humans, Male, Middle Aged, Nystagmus, Pathologic, Physical Examination, Sensitivity and Specificity, Vestibular Diseases, Video Recording, Comparative Study, Journal Article
0022-2151
1209-1215
West, P.D.B.
61dd5217-1be3-476e-abc2-00ce44bd6055
Sheppard, Z.A.
37f468e9-55b0-49dd-b1ad-c3f86dd3a263
King, E.V.
d85e0e8f-7295-4912-9052-646a790d99db
West, P.D.B.
61dd5217-1be3-476e-abc2-00ce44bd6055
Sheppard, Z.A.
37f468e9-55b0-49dd-b1ad-c3f86dd3a263
King, E.V.
d85e0e8f-7295-4912-9052-646a790d99db

West, P.D.B., Sheppard, Z.A. and King, E.V. (2012) Comparison of techniques for identification of peripheral vestibular nystagmus. The Journal of Laryngology & Otology, 126 (12), 1209-1215. (doi:10.1017/S0022215112002368).

Record type: Article

Abstract

OBJECTIVE: To determine the best clinical method for identifying peripheral vestibular nystagmus, by comparing eye movement examination with optic fixation, and with fixation removed using Frenzel's glasses, infra-red video-Frenzel's goggles or an ophthalmoscope, with results of electronystagmography.

METHOD: One hundred patients referred for electronystagmography from the audiovestibular medicine clinic at Queen Alexandra Hospital, Portsmouth, were examined immediately before undergoing electronystagmography.

RESULTS: Video-Frenzel's goggles were highly effective at detecting peripheral vestibular nystagmus, with a sensitivity of 85 per cent (95 per cent confidence interval, 62.1-96.8 per cent) and a specificity of 65 per cent (53.5-75.3 per cent), compared with electronystagmography. Ophthalmoscopy had comparable sensitivity to Frenzel's glasses (used in the dark), i.e. 26.3 per cent (9.1-51.2 per cent) compared with 31.6 per cent (12.6-56.6 per cent), respectively. Frenzel's glasses as normally used in ENT clinics (i.e. in dim lighting) were ineffective, with a sensitivity of just 10 per cent (1.2-31.7 per cent).

CONCLUSION: Video-Frenzel's goggles should be used in all clinics with substantial numbers of balance-impaired patients. Traditional Frenzel's glasses have no place in clinical practice unless formal black-out facilities are available.

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More information

e-pub ahead of print date: 26 October 2012
Published date: December 2012
Keywords: Diagnosis, Differential, Electronystagmography, Eyeglasses, Female, Fixation, Ocular, Humans, Male, Middle Aged, Nystagmus, Pathologic, Physical Examination, Sensitivity and Specificity, Vestibular Diseases, Video Recording, Comparative Study, Journal Article

Identifiers

Local EPrints ID: 416776
URI: https://eprints.soton.ac.uk/id/eprint/416776
ISSN: 0022-2151
PURE UUID: e225d14e-0cfe-453d-b082-0304f180d157

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Date deposited: 10 Jan 2018 17:30
Last modified: 13 Mar 2019 19:02

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Contributors

Author: P.D.B. West
Author: Z.A. Sheppard
Author: E.V. King

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